Laparoscopic Surgery Significantly Reduces Surgical Site Infections Compared to Open Surgery

Background: Surgical Site Infections (SSI) are known but infrequent hospital acquired infectious complications that are associated with significant morbidity, mortality and hospital costs. Recently, the U.S. Department of Human Health Services and Congress have questioned the preventive measures aimed towards hospital acquired infections. We determined and compared the incidence of SSI after laparoscopic and open surgical procedures at US academic medical centers.

Methods: Using ICD9-CM diagnosis and procedure codes of patients who underwent laparoscopic or open appendectomy, cholecystectomy, anti-reflux surgery, and gastric bypass between October 1st 2004 and June 30th 2008 were obtained from the University HealthSystem Consortium Clinical Database. The main outcome measure was in-hospital SSI after laparoscopic and open surgery.

Results: During the 45-month study period, a total of 131,630 patients underwent 1 of 4 procedures (these procedures were selected because the have specific laparoscopic and open ICD9-CM procedure codes). Overall, the incidence of SSI was significantly lower in laparoscopic (483 of 94,665; 0.5%) compared to open surgery (669 of 36,965; 1.8%; p < 0.01). Laparoscopic techniques offered a protective effect against SSI (OR = 0.28 95% CI [0.25 – 0.31]) even when stratified for severity of illness (minor: OR = 0.19; 95% CI [0.14 – 0.26]; moderate: OR = 0.30; 95% CI [0.25 – 0.35]; and major/extreme: OR = 0.65; 95% CI [0.54 – 0.79]) and admission status (elective, OR = 0.25; 95% CI [0.20 – 0.31]; urgent, OR = 0.38; 95% CI [0.28 – 0.53], and emergent, OR = 0.29; 95% CI [0.25 – 0.34]). Surgical technique was significantly associated with SSI (X2 = 517.6; p


Session: Podium Presentation

Program Number: S117

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